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分离性身份识别障碍(多重人格障碍) – 译学馆
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分离性身份识别障碍(多重人格障碍)

Me, Myself, and I: Dissociative Identity Disorder

[片头音乐]
[INTRO ♪]
1955年 一名叫雪莉·梅森的女士
In 1955, a woman named Shirley Mason
拜访了几个月来治疗她的心理医师
visited the psychotherapist she’d been seeingfor a few months.
当心理医师询问她的近况时
When the therapist asked her how she was doing,
她说:“我很好 但雪莉不好”
she said, “ I ’ m fine but Shirley isn ’ t.
“她病得很重不能来 所以我替她来了”
She was so sick she couldn’t come, so I came instead…
“我是佩琪!”
I’m Peggy!”
经过持续的心理治疗 心理医师发现
Through continued therapy, the therapist discovered what seemed like
雪莉好像拥有16种人格
16 personalities living inside Shirley’s mind.
她随后把雪莉写进了著名的书-《西比尔》
She later wrote a now-famous book about Shirley, titled”Sybil”—
用西比尔这个名字保护病人的隐私
using a different name to protect her patient’s privacy.
那本书使一个罕见的病症
And that book put a rare syndrome,
后来叫作分离性身份识别障碍变得出名
then called multiple personality disorder, on the map.
在《西比尔》之前 被报导出来的案例不到100个
Before Sybil, fewer than 100 cases had ever been reported,
但这本书问世后 诊断就激增到了上千例
but after the book came out, diagnoses explodedinto the thousands.
令人吃惊的是
In a surprising twist,
雪莉的特殊案例可能不是真的
Shirley ’ s specific case might not have been real,
她最后写信给心理医师 声称这些都是她编造出来的
and she eventually wrote her therapist claiming she’d made it all up.
但研究人员仍把这种障碍作为整体研究
But researchers are still looking into thedisorder as a whole. Today,
我们把雪莉的诊断叫作“分离性身份识别障碍”或“DID”
we call Shirley’s diagnosis dissociativeidentity disorder, or DID.
这种精神障碍经常与其它的一起出现
It often occurs alongside other psychiatricdisorders,
让诊断非常困难
making diagnosis very difficult.
并且在心理学家和精神学家中间颇具争议
And it’s still very controversial among psychologistsand psychiatrists.
但没有争议的是
But what ’ s not controversial is
好莱坞电影里刻画的与现实相去甚远
that the way Hollywood portrays it is way off.
要被确诊为DID 病人需要有
To be diagnosed with DID, a patient needsto have
两种或以上的“身份” 或稳定人格
two or more so-called “identities”, orpersonality states.
这并不意味着在人脑里
This doesn’t necessarily mean a whole otherperson
住了另一个人
is living inside their mind.
在多数案例中更像是人格分裂
In many cases, it’s more like their overallpersonality is fragmented,
由不同的历史和自我意象控制
and different parts of their history and self-imagecan take control.
比如 其中一个人格状态或许能够
For example, only one personality state mightbe able to
说在大学留学期间学到的语言
speak a language learned during a semesterabroad in college,
然而另一个并不记得那段经历
while another doesn’t remember that experience.
或者如果他们以前是一个虔诚的教徒
Or if they’d previously been a very religiousperson,
他们也许会有一个虔诚的分裂人格
they might have one fragment of them that ’ s devout,
以及另一个不虔诚的分裂人格
and another that isn ’ t.
有时候这些分裂的人格会表现出
Sometimes these fragments present themselvesas multiple people
不同年龄或性别特征 但不总是如此
with different ages or genders, but not always.
这些分裂的人格可能非常复杂
And while these fragments can be complicated,
他们有自己的欲望和冲动 没法得到满足
with their own wants and aspirations, they
比如邪恶或犯罪的欲望
aren’t there to fulfill,like, evil or criminal desires.
因此患有DID的人
So the idea that people with DID are ruled
是被他们最邪恶的那部分人格控制
by the worst parts of themselves,
《搏击俱乐部》或《分裂》电影传达的观念是完全虚假的
like in Fight Club or Split, is entirely fictional.
另一个主要的症状是记忆缺失或健忘症
The other major symptom is memory loss oramnesia.
当他们的另一个分裂人格占上风时
This could be missing personal informationabout themselves,
可能会忘记自己的个人信息或者偶尔失忆
or missing memories from times when another personality fragment was in control. Also,
此外 如果人格转变或记忆缺失是
it doesn’t count if the personality shift
化学因素引起的则不算数
or memory loss are chemically-induced.
如果每个人告诉你
If everyone tells you that you turn
当你喝醉时变成了另一个人
into someone else when you’re drunk,
但是你并不记得你说了或做了什么
but you can’t remember what you said ordid …
你并不患有分离性身份识别障碍
you do not have dissociative identity disorder. And,
同时 父母们:孩子有假想朋友?
parents: imaginary friends?
完全没有关系
Totally cool.
这种现象很普遍 大概三分之二的孩子都有假想朋友
They’re really common— like, 2/3 of kidshave them—
这并不是孩子拥有另一个隐秘人格的症状
and this is not a symptom of your child harboring another secret personality.
不过如果一个病人有多重身份 记忆不稳定
But if a patient has multiple identities,their memory is shaky,
并且这些症状令他们痛苦受损
and they’re distressed or impaired by thesesymptoms,
那么心理医师可能会诊断他们患有DID
then a psychiatrist might diagnose them withDID. Many,
但是很多心理医师不会这样
though, wouldn’t.
并不是因为他们的情况不真实
It’s not that their condition isn’t real—
毫不否认病人有这些症状
there’s no denying that patients have these symptoms.
但是专家对症状来源有分歧
But experts disagree on where the symptomscome from—
是否DID是一个独立的障碍
whether DID is a stand-alone disorder,
或者用其它已确立的障碍解释
or whether it ’ s better explained by other,
比较好
well-established disorders.
调查发现大多数心理医师同意这是一个有效的诊断
Surveys of psychiatrists found that most agreeit’s a valid diagnosis,
但是大多数认为这种障碍普遍被误诊
but many think it’s commonly misdiagnosed.
一部分原因是因为分离性身份识别障碍太罕见
That ’ s partly because DID is so rare,
多数研究只有非常少的样本
most studies on it have very small samples.
但是也是因为病人不太可能
But it ’ s also because it’s very unlikely
只患有分离性身份识别障碍
that patients get just a DID diagnosis.
通常附加在其它诊断之上
It ’ s usually tacked on to other diagnoses,
这就是大多数心理医师
and this is one reason why many psychologists
认为DID是其它障碍的极端案例
think thatit’s better understood as an extreme version
更容易理解的原因
of other disorders.
比如 DID与分离神游症很相似
For example, DID can look a lot like a dissociative fugue state.
分离神游症
This is a kind
是短暂性记忆缺失的一种
of temporary memory loss where people behave impulsively,
人们突然离家并神游
leave their homes and wander around,
做一些从来不会做的事情
and do things that they would never otherwise do.
看上去像人格的转变
So it might seem like a shift in personality.
这些人也经常缺失身份的记忆
These people also often lose their memoriesof who they are,
因此有时会捏造一个新身份填补记忆空白
so they sometimes invent a new identity to fill in the gap.
尽管大量的
And although a lot
虽然神游病例有些神秘
of these fugue cases are a bit of a mystery,
但有些可以通过药物滥用或精神障碍来解释
some are explained by substance use or neurologicalconditions.
DID与创伤后精神紧张性精神障碍或称PTSD
DID also overlaps a lot with post-traumaticstress disorder,
有很多相似的地方
or PTSD.
这特别有趣 因为那些坚信
That’s especially interesting, because thepsychologists
DID是一种不同的障碍的心理医师
who most strongly believe DID is a distinctdisorder
认为DID的根源是童年创伤或虐待 而这也是PTSD的根源
think it stems from childhood trauma or abuse— which could also cause PTSD.
并且DID与边缘性人格障碍有类似的病症
And DID similarly shares symptoms with borderlinepersonality disorder,
边缘性人格障碍的特征是行为冲动 人际关系与身份的不稳定
which is characterized by impulsive behavior, as well as unstable relationships and identity.
20世纪80年代的对33名病人的研究发现
One study of 33 patients in the 1980s found
70%患有DID的病人可以很容易
that 70 % of patients with DID
被诊断为边缘性人格障碍
could have just as easily been diagnosed with borderline personality disorder instead. But,
但是 研究人员得出结论
the researchers concluded that because30% of the cases
因为30%的病例不同 DID应该被看作是一种独立的障碍
were distinct, DID should be considered astand-alone disorder.
DID也是有争议的 因为大多数的新诊断
DID is also controversial because many ofthe new diagnoses
貌似仅仅来源于小部分心理医师
seem to be coming from just a few psychiatrists,
并且一些人指出这些医生可能过度热心了
and some suggest these doctors may be overzealous
因为他们急于寻找新病例
because they’re eager to find new cases.
但是医生们自己反驳说
But the doctors themselves counter that bysaying that
他们只是在发现迹象辨别障碍方面做得更好
they’re just better at seeing the signsand identifying the disorder. Regardless,
好消息是
the good news is
针对DID的个性化治疗
that treatment for DID with tailored therapy—
至少针对与人格分裂有关的症状
at least for the symptoms related to identityfragmentation—
是非常有效的
is pretty effective.
这样很棒 因为尽管对于DID有
Which is great, because although there’sa lot of controversy
大量的争议 心理医师都同意
surrounding the disorder, psychiatrists allagree that
现实中的人们饱受折磨并需要帮助
real people are suffering and need help.
像其他人一样 他们应该得到同情
And like anyone else, they should be showncompassion,
并不能在电影里被刻画成怪物
and not made into movie monsters.
多谢观看本期“心理科学秀”
Thanks for watching this episode of SciShow Psych.
如果想学习更多关于心理创伤的内容
If you want to learn more about the psychologyof trauma,
你可能会对《创伤是如何遗传的》一期感兴趣
you might be interested in our episode on how trauma can be inherited.
[片尾音乐]
[OUTRO ♪]

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视频详细介绍了分离性身份识别障碍的特征以及大家对此病症的误解

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视频来源

https://www.youtube.com/watch?v=l4hVtBV5o4s

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